前列腺癌中鳞状分化的诊断困境：一例报告

The diagnostic dilemma of squamous differentiation in prostate cancer: A case report.

作者信息

Majeed Abdul-Jawad J, Warrick Joshua, Raman Jay D

机构信息

Penn State College of Medicine, University Park Regional Campus, State College, PA, USA.

Department of Pathology and Laboratory Medicine, Penn State College of Medicine, Hershey, PA, USA.

出版信息

Urol Case Rep. 2025 Apr 4;60:103034. doi: 10.1016/j.eucr.2025.103034. eCollection 2025 May.

DOI:10.1016/j.eucr.2025.103034

PMID:40248516

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12004368/

Abstract

Squamous differentiation in prostate cancer is rare, presenting unique diagnostic and therapeutic challenges. We report a case of high-grade prostatic adenocarcinoma with focal squamous differentiation in a 73-year-old man without prior radiation or androgen deprivation. Immunohistochemistry confirmed the squamous component arose from the adenocarcinoma, not a separate malignancy. This case highlights the importance of morphological assessment and strategic immunohistochemical evaluation to distinguish prostate cancer variants. A biopsy capturing only the squamous component could have led to misdiagnosis and inappropriate treatment. To improve diagnostic accuracy and management, we propose the term 'adenocarcinoma with focal squamous differentiation' over adenosquamous carcinoma.

摘要

前列腺癌中的鳞状分化很少见，带来了独特的诊断和治疗挑战。我们报告了一例73岁男性的高级别前列腺腺癌伴局灶性鳞状分化，该患者既往未接受过放疗或雄激素剥夺治疗。免疫组织化学证实鳞状成分起源于腺癌，而非独立的恶性肿瘤。该病例强调了形态学评估和策略性免疫组织化学评估对于区分前列腺癌变异型的重要性。仅获取鳞状成分的活检可能导致误诊和不恰当的治疗。为提高诊断准确性和管理水平，我们建议使用“伴局灶性鳞状分化的腺癌”这一术语，而非腺鳞癌。